Schizophrenia: Information for Consumers, Families and Caregivers

Summary: Schizophrenia is a severe, lifelong brain disorder that causes changes in your thoughts, perceptions, emotions and behaviours. It can make you hear or see things that others cannot see. It can make you have beliefs that others do not believe, such as feeling that others are out to harm you. It can be extremely stressful, because these symptoms can cause troubles with relationships, with work and school. The good news is that there is help and treatment that can help get things better again.

Introduction

Schizophrenia is a serious brain disorder that causes changes in a person's thoughts, perceptions, emotions and behaviours. It can make someone hear or see things that others cannot see. It can make someone feel unsafe, afraid, and lead to avoiding other people, and loss of function. Without proper treatment, it can cause serious problems with school, work and relationships. Fortunately, help is available for those with schizophrenia. In addition, there are many things that family and friends can do to support their loved ones with schizophrenia.

Do I Have Schizophrenia?

The following is a list of some symptoms of schizophrenia. If you (or a loved one) have these symptoms, speak with a doctor.

What are the Symptoms of Schizophrenia?

Hallucinations: Hearing voices is the most common type of hallucination in schizophrenia. Some people hear one voice, others hear many. These voices sound like a voice inside the person's head. The voice may make comments about the person, or be critical and say mean things. Or the voice may order the person around and tell them to do things. Other types of hallucinations include seeing people or objects that are not there.

Delusions: Delusions are strong personal beliefs that not commonly accepted by others. Types of delusions include:

Delusions of reference: You feel that others are talking about you. For example, when you turn on the television, or read the newspaper, you feel that its about you.

Delusions of persecution: You feel that others are out to harm you. Wherever you go, you may feel that people are spying on you, following you, and planning to harm you in some way.

2. Passive (or "Negative symptoms") symptoms are a loss of skills or abilities, such as having a loss or decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life. These symptoms are harder to recognize as part of the disorder and can be mistaken for laziness or depression. You may notice that its hard to think clearly.

How Common Is It?

What Causes Schizophrenia?

There is no one single cause for schizophrenia, however there are different factors which can increase a person's risk of getting schizophrenia:

Family history: Being related to other family members with schizophrenia can increase a person's risk of getting schizophrenia.

Drug use: Using certain types of drugs, such as marijuana, or alcohol can increase a risk of psychosis. In people at high risk (e.g. such as those with family members with schizophrenia or psychosis), it is safest to avoid stimulants (such as cocaine, amphetamines), marijuana or PCP ("angel dust").

Stress: Having significant stress from school, work, home or relationships can increase one's risk.

How is Schizophrenia Treated?

Although there is no cure for schizophrenia, there are many treatments that can help significantly such as:

Medications, and

Psychosocial interventions such as counselling/therapy.

Treatment: Medications

Medications that treat psychosis (antipsychotic medications) are effective in reducing symptoms such as hallucinations and delusions.

The original antipsychotic medications include chlorpromazine (Thorazine®), haloperidol (Haldol®), perphenazine (Etrafon®, Trilafon®), and fluphenzine (Prolixin®). The older medications can cause movement side effects, such as rigidity, persistent muscle spasms, tremors, and restlessness.

In the 1990s, new drugs, called atypical antipsychotics, were developed that rarely produced these side effects. Examples include: risperidone (Risperdal®), olanzapine (Zyprexa®), quietiapine (Seroquel®), sertindole (Serdolect®), and ziprasidone (Geodon®).

Everyone responds differently to antipsychotic medication. Sometimes several different drugs must be tried before the right one is found.

When on a new medication, agitation and hallucinations usually improve within days and delusions usually improve within a few weeks. Many people see substantial improvement in both types of symptoms by the sixth week of treatment. No one can tell beforehand exactly how a medication will affect a particular individual, and sometimes several medications must be tried before the right one is found.

If side effects occur, you can try waiting until they go away. When people first start to take atypical antipsychotics, they may become drowsy; experience dizziness when they change positions; have blurred vision; or develop a rapid heartbeat, menstrual problems, a sensitivity to the sun, or skin rashes. Many of these symptoms will go away after the first days of treatment, but people who are taking atypical antipsychotics should not drive until they adjust to their new medication.

How Long Do I Need to take medications?

Like diabetes or asthma, schizophrenia is a lifelong condition that needs constant attention. Although it cannot be cured, treatment can significantly improve the quality of your life. Most people with schizophrenia need to take some type of medication for the rest of their lives as well as receive other help, such as counselling/therapy.

Don't Stop Your Medication Without Speaking to Your Doctor

When you have schizophrenia, it is important to take your medication regularly, because by doing so, you will have less symptoms of psychosis.

Relapses (return of symptoms of psychosis) occur most often when people with schizophrenia stop taking their medication.

If you want to stop taking your medication, then speak with your doctor. Your doctor can help find other options.

Common Reasons that People Stop Taking Medications

Reasons Why You Might Feel Like Stopping Your Medication

I'm feeling better and I don't need the medication. If you're feeling better, that's great because it means the medication is doing its job.

Its hard to remember to take my medication. Ask the pharmacist at the drug store about ways to make it easier to take your medication. Common ways include:

You can get a special medication pillbox that has different days of the week

You can take your medications with meals

You can set reminders on your alarm or watch

I don't like the way the medication makes me feel; I think I may be having side effects. The good news is that often side effects go away on their own over time. But if you are having side effects that are troubling you, its better to let your doctor (or pharmacist) know about it, rather than just stop your medication.

Treatment: Non-Medication and Psychosocial Treatments

In addition to medications, many other things are important:

Learning about how to manage schizophrenia. It helps significantly when the person with schizophrenia, as well as family and close friends learn about how to support the person with schizophrenia.

Key things include:

Basic facts about schizophrenia

Being aware of early warning signs of relapse, and knowing what to do if there are signs of relapse

Coping skills to deal with persistent symptoms

Getting help for any substance abuse. Many people with schizophrenia end up with problems with drugs or alcohol Getting help for these problems is very important.

Work and vocational training. Because schizophrenia often strikes at the critical years of 18-35, it may stop people from being able to finish their education or find a job. Special programs geared for those with schizophrenia can help with finding work.

Family Education. Patients with schizophrenia are often discharged from the hospital into the care of their families, so it is important that family members know as much as possible about schizophrenia.

Self-Help Groups. Self-help groups for those with schizophrenia and families can provide a unique support that professionals cannot. Self-help groups are composed of people dealing with the same issues, and are a powerful way of getting mutual support from one another. It helps to know that you are not the only way dealing with an issue, and its helpful to be able to benefit from the knowledge of others going through the same thing. In addition, self-help groups in the long run can advocate and help change the system to better serve those with schizophrenia.

Self-Help for Schizophrenia

There are many things that friends, family and caregivers can do to help:

Emotional support: Give emotional support to your loved one. Tell things such as "I want you to know that I'm here for you. How can I help you?" "Tell me what I can do to support you." When your loved one feels safe to turn to you, it makes it much more easier for you to make suggestions or advice for your loved one.

Helping your loved one get treatment. If your loved one is not even wanting to get help, you may need to speak with doctors or others in order to learn how to find help.

Helping your loved one follow through with treatment. Even if your loved one has professional help, it can still be hard to follow through with treatment. You can help by offering to accompany or take your loved one to doctor's appointments. If medications have been prescribed, then support the person in taking their medications. On the other hand, if you do not feel the medications are helpful, you can tell their doctor as well.

Validate feelings even if you can't validate delusions. How should you respond when someone with schizophrenia makes statements that are strange or clearly false?

Because these bizarre beliefs or hallucinations are real to the patient, it will not be useful to say they are wrong or imaginary. Going along with the delusions if you do not believe it will not be helpful, either. What you can do is you can validate how the delusions make your loved one feel, and support them with that. For example, if your loved one is feeling scared from feeling that they are being followed by the CIA, then you can validate how scary that must be, and offer your support. You may have to set limits as well on what you can and cannot do.

You can calmly say that you see things differently than the patient does but that you acknowledge that everyone has the right to see things in his or her own way.

Don't invalidate your loved one. Even if your loved one expresses viewpoints that you completely disagree with (e.g. delusions), don't laugh or tell the other person that s/he is 'stupid' or 'crazy', nor say 'Its all in your head', as this will make the other person less interested in confiding with you. You can validate that for them, their experience feels real, and it is upsetting.

Get support from people that your relative trusts. If there is a particular person that your relative trusts (and if you trust that person as well!), enlist that person's help.

Reduce stress. Psychosis is made worse if the person is under a lot of stress. Help the person identify what stresses they are under, and come up with a plan to deal with each one of them.

Ensure healthy lifestyle. Help your loved one with lifestyle interventions such as:

Eating properly (e.g. three nutritious meals a day with healthy snacks)

Getting enough sleep

Get enough time outside with physical activity

Avoiding street drugs or stimulants, or other drugs.

Keep things calm and avoid over stimulation. Psychosis makes people sensitive to being overloaded. If there is too much going on (e.g. if too many people are around), help the person with psychosis to take a break by suggesting a quiet walk or having nap...

Have a schedule. People with schizophrenia do best when they have structure in their lives, i.e. having a routine or schedule. Get a daily planner, scheduler or calendar. Write down in your schedule what daily activities you have, and at what times. Some people like to have a schedule made up well in advance. Other people may prefer a schedule made up a week before, or even just the day before.

Support systems are vital. Especially when a person has schizophrenia, it is essential to have a good support network, which may include professionals, friends and family. Are there any other people that should be part of your loved one's support network? Contact them to get them involved.

Care for the caregiver. If you are looking after someone with psychosis, make sure that you have someone to talk to who understands your experience, and that you take a break too! If you get burnt out, then who will look after your loved one?

In Case of Crisis: Tips for Families

When they are unwell, people with schizophrenia may resist treatment, believing that their delusions or hallucinations are real and psychiatric help is not required.

If it gets to the point that a crisis occurs, family and friends may need to take action to keep their loved one safe.

Although the exact laws may vary depending on where one lives, if a person is dangerous and unable to care for oneself due to mental illness, family/friends can contact a doctor (or police) to ask how to take a person to the hospital.

In the emergency room, a mental health professional will assess the patient and determine the best course of action. It may involve an admission to hospital, or other options.

A person who does not want treatment may hide strange behavior or ideas from a professional; therefore, family members and friends can ask to speak privately with the person conducting the patient's examination and explain what has been happening at home. The professional will then be able to question the patient and hear the patient's distorted thinking for themselves. Professionals must personally witness bizarre behavior and hear delusional thoughts before they can legally recommend commitment, and family and friends can give them the information they need to do so.

After the Crisis

Caregiving. Ensuring that people with schizophrenia continue to get treatment and take their medication after they leave the hospital is also important. If patients stop taking their medication or stop going for follow-up appointments, their psychotic symptoms will return. If these symptoms become severe, they may become unable to care for their own basic needs for food, clothing, and shelter; they may neglect personal hygiene; and they may end up on the street or in jail, where they rarely receive the kind of help they need.

Family and friends can also help patients set realistic goals and regain their ability to function in the world. Each step toward these goals should be small enough to be attainable, and the patient should pursue them in an atmosphere of support. People with a mental illness who are pressured and criticized usually regress and their symptoms worsen. Telling them what they are doing right is the best way to help them move forward.

Summary

Schizophrenia is a serious brain disorder that causes changes in a person's thoughts, perceptions, emotions and behaviours. It can make someone hear or see things that others cannot see. It can make someone feel unsafe, afraid, and lead to avoiding other people, and loss of function. Without proper treatment, it can cause serious problems with school, work and relationships. Fortunately, help is available for those with schizophrenia. In addition, there are many things that family and friends can do to support their loved ones with schizophrenia.

About this Document

Written by the eMentalHealth Team.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

Creative Commons License

You are free to copy and distribute this material in its entirety as long as 1) this material is not used in any way that suggests we endorse you or your use of the material, 2) this material is not used for commercial purposes (non-commercial), 3) this material is not altered in any way (no derivative works). View full license at http://creativecommons.org/licenses/by-nc-nd/2.5/ca/

Patient Handouts

Overview
Atypical antipsychotics (aka “third-generation antipsychotics”) are a group of medications that are used in various conditions including schizophrenia and mood conditions. (These medications are called “antipsychotics”, because they were originally used mainly in conditions with psychosis such as schizophrenia, however medications in this group are also used with other conditions as well, such as mood conditions.
Medications in this group (generic name followed by the tradename®) include:
Aripiprazole (Abilify®)
Ziprasidone (Geodon®)
Risperidone ...

Dave’s Story
Dave is a 10-yo boy who has started to hear voices. He has always been somewhat quiet, and not been that talkative about his thoughts and feelings. The voices appear triggered when he is under more stress, e.g. conflicts with classmates or not understanding work at school. When he is angry, the voices are angry. When he is feeling good, the voices are nice…
How Common are Voices?
Studies show that voices are quite common, though the exact numbers vary depending on the study:
At a single point in time
About 2-3% of the general population hears voices (Tien, 1991)
In ...

Medication Information

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What medications are used to treat schizophrenia?
Antipsychotic medications are used to treat schizophrenia and schizophrenia-related disorders. Some of these medications have been available since the mid-1950's. They are also called conventional "typical" antipsychotics. Some of the more commonly used medications include:
Chlorpromazine (Thorazine)
Ha...

Antipsychotic medications are used to treat schizophrenia and schizophrenia-related disorders. Some of these medications have been available since the mid-1950's. They are also called conventional "typical" antipsychotics. Some of the more commonly used medications include:

Chlorpromazine (Thorazine)

Haloperidol (Haldol)

Perphenazine (generic only)

Fluphenazine (generic only).

In the 1990's, new antipsychotic medications were developed. These new medications are called second generation, or "atypical" antipsychotics.

One of these medications was clozapine (Clozaril). It is a very effective medication that treats psychotic symptoms, hallucinations, and breaks with reality, such as when a person believes he or she is the president. But clozapine can sometimes cause a serious problem called agranulocytosis, which is a loss of the white blood cells that help a person fight infection. Therefore, people who take clozapine must get their white blood cell counts checked every week or two. This problem and the cost of blood tests make treatment with clozapine difficult for many people. Still, clozapine is potentially helpful for people who do not respond to other antipsychotic medications.

Other atypical antipsychotics were developed. All of them are effective, and none cause agranulocytosis. These include:

Risperidone (Risperdal)

Olanzapine (Zyprexa)

Quetiapine (Seroquel)

Ziprasidone (Geodon)

Aripiprazole (Abilify)

Paliperidone (Invega).

The antipsychotics listed here are some of the medications used to treat symptoms of schizophrenia. Additional antipsychotics and other medications used for schizophrenia are listed in the chart at the end.

Note: The FDA issued a Public Health Advisory for atypical antipsychotic medications. The FDA determined that death rates are higher for elderly people with dementia when taking this medication. A review of data has found a risk with conventional antipsychotics as well. Antipsychotic medications are not FDA-approved for the treatment of behavioral disorders in patients with dementia.

What are the side effects?

Some people have side effects when they start taking these medications. Most side effects go away after a few days and often can be managed successfully. People who are taking antipsychotics should not drive until they adjust to their new medication. Side effects of many antipsychotics include:

Drowsiness

Dizziness when changing positions

Blurred vision

Rapid heartbeat

Sensitivity to the sun

Skin rashes

Menstrual problems for women.

Atypical antipsychotic medications can cause major weight gain and changes in a person's metabolism. This may increase a person's risk of getting diabetes and high cholesterol.1 A person's weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical antipsychotic medication.

Typical antipsychotic medications can cause side effects related to physical movement, such as:

Rigidity

Persistent muscle spasms

Tremors

Restlessness.

Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person can't control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.

Every year, an estimated 5 percent of people taking typical antipsychotics get TD. The condition happens to fewer people who take the new, atypical antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication.

How are antipsychotics taken and how do people respond to them?

Antipsychotics are usually pills that people swallow, or liquid they can drink. Some antipsychotics are shots that are given once or twice a month.

Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement.

However, people respond in different ways to antipsychotic medications, and no one can tell beforehand how a person will respond. Sometimes a person needs to try several medications before finding the right one. Doctors and patients can work together to find the best medication or medication combination, and dose.

Some people may have a relapse—their symptoms come back or get worse. Usually, relapses happen when people stop taking their medication, or when they only take it sometimes. Some people stop taking the medication because they feel better or they may feel they don't need it anymore. But no one should stop taking an antipsychotic medication without talking to his or her doctor. When a doctor says it is okay to stop taking a medication, it should be gradually tapered off, never stopped suddenly.

How do antipsychotics interact with other medications?

Antipsychotics can produce unpleasant or dangerous side effects when taken with certain medications. For this reason, all doctors treating a patient need to be aware of all the medications that person is taking. Doctors need to know about prescription and over-the-counter medicine, vitamins, minerals, and herbal supplements. People also need to discuss any alcohol or other drug use with their doctor.

To find out more about how antipsychotics work, the National Institute of Mental Health (NIMH) funded a study called CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness). This study compared the effectiveness and side effects of five antipsychotics used to treat people with schizophrenia. In general, the study found that the older medication perphenazine worked as well as the newer, atypical medications. But because people respond differently to different medications, it is important that treatments be designed carefully for each person. You can find more information on CATIE here.

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The photos in this publication are of models and are used for illustrative purposes only.

School Letter

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I am writing to give you an update regarding your student.
Your student is coping with psychosis, which is a brain condition that affects thinking and concentration.
Accommodations are essential for this student to function in the academic program. Specific accommodations will need to be devised for this student in collaboration with the youth and family. A general...

Your student is coping with psychosis, which is a brain condition that affects thinking and concentration.

Accommodations are essential for this student to function in the academic program. Specific accommodations will need to be devised for this student in collaboration with the youth and family. A general list includes the following:

Support Re-Integration

Ensuring that educators are aware that this student is going through a difficult period, so that they can be more understanding, i.e. that any current difficulties in learning are more because of an illness, rather than an attitude problem or poor parenting

Designate key school personnel (e.g. resource teacher, guidance counselor, etc.) to regularly meet and check in with the student to see how things are going

Do not expect this student to be able to take the initiative in going to teachers; rather, teachers should take the initiative in checking with the student

Specific areas to ask would include:

How are things going?

What's going well?

What's not going well, i.e. what is stressful?

Is there anything we can do to problem-solve this stress?

Reduce sensory stress

Work with the student to come up with a way for the student to let you know when s/he is becoming overwhelmed by sensory stress

Agree upon a low-stimulation, quiet, soothing place where the student can go if s/he is starting to feel overwhelmed

This student has problems with sensory stress, in that this student can be easily overwhelmed by seemling normal levels of sensory input

Auditory stress

Give advance notice of fire drills

Allow her to use ear plugs in class

Allow her to sit nearer the front of class (if she desires)

Provide quiet places when needed for intense work

Visual stress

Allow her to wear baseball cap or sweatshirt with a hood (in order to block out fluorescent light)

Consider glasses that automatically darken with glare

Tactile stress

Due to the stress of bumping into peers during busy hallway times, give her the option of going between classes when it is less busy

Do not touch this student unexpectedly or without permission

Accommodations for thinking difficulties

Accept that the student may require more time for doing school work as well as for tests

Medications are often prescribed for this student's condition

If the student appears tired and drowsy, realize that this may be an unavoidable medication side effect, and is not the student's fault

Help monitor for worsening

If you notice that this student's function is worsening, then inform parents

Thank you for your time. Feel free to contact me if you have any further questions!

Workplace Accommodation

Add to Info Cart

To whom it may concern:
I would like to give you an update regarding this individual.
Unfortunately, your employee has been off-work due to a health condition.
Fortunately, your employee is feeling better, and would like to return to work.
The following section has a list of common recommendations that may maximize the chances of a suc...

Unfortunately, your employee has been off-work due to a health condition.

Fortunately, your employee is feeling better, and would like to return to work.

The following section has a list of common recommendations that may maximize the chances of a successful return to work, which are in both employee and employer’s best interests.

The suggested recommendations are only a general guide, and it is always best to speak with the employee and customize the recommendations for your specific employer/employee situation.

Recommended Accommodations/Modifications for Employers

A flexible schedule that has

Flex-time or a part-time position

Time off for scheduled medical appointments

Workspace where visual and auditory distractions are minimized.

Visual sensitivity: Too much visual stimulation, which may include visual clutter, or bright lighting (e.g. fluorescent lighting) may be stressful. Allow the employee to make accommodations if necessary such as dimmer lighting, or wear a cap to block out overhead ambient light.

Auditory sensitivity: Too much sounds may be stressful.

Flexible break times that meet the individual's needs rather than following a fixed schedule. As with a worker with back pain, if a worker is feeling overwhelmed, it is sometimes the case that the worker will need to immediately sit down, rather than keep on working and risk re-injuring his/her back. Thus, ideally the work can be structured so that if absolutely necessary, the worker can take more flexible breaks, depending on how the worker is doing that day.

Additional leave from work after a hospitalization. With the current trend towards shorter and shorter inpatient hospital admissions, even if your employee has been discharged from hospital, it does not mean that your employee is ready for work. Most of the time, there is additional time at home that is required for the patient’s recovery.

Giving the employee opportunities to phone his/her health professionals during the day if necessary. From time to time, your employee may be needing to contact his/her health care team during the daytime, for issues such as making medication adjustments, discussing side effects. Allowing your worker those opportunities will help your employee to stay healthy, ultimately resulting in less sick days.

The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) guidelines provide parents and doctors with information about the side effects of antipsychotic drugs in children.

Psychosis can be treated, early detection helps, and recovery is expected. The Early Psychosis Intervention Ontario Network (EPION) provides support, information, and care for people suffering from psychosis.

OurHealthyMinds is about mental health. It celebrates the many ways we can be well, and honours the many ways we can experience mental illness - as an individual, a caregiver, a parent, a child or loved one.

Care Plan

Screening Tools on eMentalHealth.ca

is a serious condition that can cause problems with confused thinking and hallucinations (seeing or hearing things that others cannot). It can also make a person feel that others are out to harm him/her, which is a particularly frightening.

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Clinical Practice Guidelines

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CAMESA Guidelines

Published

2011

Produced By

Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotic Medications in Children (CAMESA)

School Letter

Add to Info Cart

I am writing to give you an update regarding your student.
Your student is coping with psychosis, which is a brain condition that affects thinking and concentration.
Accommodations are essential for this student to function in the academic program. Specific accommodations will need to be devised for this student in collaboration with the youth and family. A general...

Your student is coping with psychosis, which is a brain condition that affects thinking and concentration.

Accommodations are essential for this student to function in the academic program. Specific accommodations will need to be devised for this student in collaboration with the youth and family. A general list includes the following:

Support Re-Integration

Ensuring that educators are aware that this student is going through a difficult period, so that they can be more understanding, i.e. that any current difficulties in learning are more because of an illness, rather than an attitude problem or poor parenting

Designate key school personnel (e.g. resource teacher, guidance counselor, etc.) to regularly meet and check in with the student to see how things are going

Do not expect this student to be able to take the initiative in going to teachers; rather, teachers should take the initiative in checking with the student

Specific areas to ask would include:

How are things going?

What's going well?

What's not going well, i.e. what is stressful?

Is there anything we can do to problem-solve this stress?

Reduce sensory stress

Work with the student to come up with a way for the student to let you know when s/he is becoming overwhelmed by sensory stress

Agree upon a low-stimulation, quiet, soothing place where the student can go if s/he is starting to feel overwhelmed

This student has problems with sensory stress, in that this student can be easily overwhelmed by seemling normal levels of sensory input

Auditory stress

Give advance notice of fire drills

Allow her to use ear plugs in class

Allow her to sit nearer the front of class (if she desires)

Provide quiet places when needed for intense work

Visual stress

Allow her to wear baseball cap or sweatshirt with a hood (in order to block out fluorescent light)

Consider glasses that automatically darken with glare

Tactile stress

Due to the stress of bumping into peers during busy hallway times, give her the option of going between classes when it is less busy

Do not touch this student unexpectedly or without permission

Accommodations for thinking difficulties

Accept that the student may require more time for doing school work as well as for tests

Medications are often prescribed for this student's condition

If the student appears tired and drowsy, realize that this may be an unavoidable medication side effect, and is not the student's fault

Help monitor for worsening

If you notice that this student's function is worsening, then inform parents

Thank you for your time. Feel free to contact me if you have any further questions!

Workplace Accommodation

Add to Info Cart

To whom it may concern:
I would like to give you an update regarding this individual.
Unfortunately, your employee has been off-work due to a health condition.
Fortunately, your employee is feeling better, and would like to return to work.
The following section has a list of common recommendations that may maximize the chances of a suc...

Unfortunately, your employee has been off-work due to a health condition.

Fortunately, your employee is feeling better, and would like to return to work.

The following section has a list of common recommendations that may maximize the chances of a successful return to work, which are in both employee and employer’s best interests.

The suggested recommendations are only a general guide, and it is always best to speak with the employee and customize the recommendations for your specific employer/employee situation.

Recommended Accommodations/Modifications for Employers

A flexible schedule that has

Flex-time or a part-time position

Time off for scheduled medical appointments

Workspace where visual and auditory distractions are minimized.

Visual sensitivity: Too much visual stimulation, which may include visual clutter, or bright lighting (e.g. fluorescent lighting) may be stressful. Allow the employee to make accommodations if necessary such as dimmer lighting, or wear a cap to block out overhead ambient light.

Auditory sensitivity: Too much sounds may be stressful.

Flexible break times that meet the individual's needs rather than following a fixed schedule. As with a worker with back pain, if a worker is feeling overwhelmed, it is sometimes the case that the worker will need to immediately sit down, rather than keep on working and risk re-injuring his/her back. Thus, ideally the work can be structured so that if absolutely necessary, the worker can take more flexible breaks, depending on how the worker is doing that day.

Additional leave from work after a hospitalization. With the current trend towards shorter and shorter inpatient hospital admissions, even if your employee has been discharged from hospital, it does not mean that your employee is ready for work. Most of the time, there is additional time at home that is required for the patient’s recovery.

Giving the employee opportunities to phone his/her health professionals during the day if necessary. From time to time, your employee may be needing to contact his/her health care team during the daytime, for issues such as making medication adjustments, discussing side effects. Allowing your worker those opportunities will help your employee to stay healthy, ultimately resulting in less sick days.